跨导管三门干预后的替代节奏策略:程序性挑战和经验教训
Emily Tat1, Tamim Nazif1, Isaac George1
1Department of Medicine, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, New York.
Heart rhythm
|October 12, 2025
概括
包括冠状动脉鼻 (CS) 和无心脏起器 (LP) 放置在内的非跨膜节奏策略,在经过跨管三管干预 (TTVI) 后需要起器的患者中显示可行性和安全性. 多学科规划是优化这些复杂案例成功的关键.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 由于解剖学和程序的复杂性,对心脏起器植入后三管干预 (TTVI) 的决策具有挑战性.
- TTVI包括过导管边缘到边缘修复 (TEER) 和过导管三管置换 (TTVR).
研究的目的:
- 评估TTVI后替代步调策略的可行性.
- 评估非跨管节拍选项,如冠状动脉鼻 (CS) 或无心脏起器 (LP) 放置.
主要方法:
- 连续在一个机构接受TTVI的患者的回顾性分析.
- 评估新的起器指示和使用的节奏策略.
- 评估非跨管心脏起器植入的程序挑战和结果.
主要成果:
- 在103名患者中,有15%的患者在TTVI后出现了节拍指示 (9%在TEER后,20%在TTVR后).
- 在CS领先的安置成功率在TEER后为50%,在TTVR后为75%.
- 在TTVR后的2名患者中,无心脏起器 (LP) 放置是100%的成功.
- 没有报告与手术前或1年设备相关的不良事件.
结论:
- 对于在TTVI后需要心脏起器的患者来说,非跨管节奏策略似乎是可行的和安全的.
- 涉及多学科团队的程序前规划对于程序成功至关重要.
- 进一步的研究和长期跟进是必要的,以充分建立这些战略.
相关概念视频
Cardiac Catheterization IV: Nursing Management
644
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
644
Mitral Stenosis III: Medical Management
246
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
246
Cardiac Catheterization III: Left Heart Catheterization
577
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
577
Cardiac Catheterization I: Pre-Procedure Overview
1.1K
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
1.1K
Mitral Stenosis IV: Nursing Management
247
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
247
Mitral Regurgitation III: Medical Management
279
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
279


